Carrier Conundrums | KO or GOOD TO GO | Surprising State Specifics | Dastardly Declinable Drugs | Miscellaneous Madness |
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What are Aetna companies (Accendo, Aetna, Puritan, SGIC, USIC, Capitol) and Cigna?
Carriers that do not ask about tobacco use.
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What is a KO?
A client who says they are pre-diabetic and had a stroke 10 years ago.
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What are CA, FL, ME, MN, OR, and WA?
In these states, UHC will decline a client instead of rating them up to level 2 for certain health conditions.
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What is methotrexate and prednisone?
These are two common drugs used to treat Rheumatoid Arthritis, and are HKO with most carriers.
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What is Mutual of Omaha?
This carrier is most lenient with blood thinners, commonly used to treat A-fib.
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What is the Aetna family?
The only carrier that will accept a client with COPD.
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What is Good to Go?
A client who had a procedure done for a carcinoma last week and has no follow ups
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What are CT, ID, IL, OH, OK, RI
These states are 2 applicants always for household discounts.
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What is Oxygen use and Nebulizer use?
These common treatments for COPD are declinable with all carriers.
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What is Maryland?
This state requires a 7 year lookback on all health questions.
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What is Cigna?
This company declines (or rates up, if applicable) for diabetes + tobacco use
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What is Good To Go?
A client who has to use a cane when out and about, like at the grocery store, or when she takes her grand kids to the zoo.
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What is Oregon?
The state that has an annual Open Enrollment period where clients can switch like to like or like to lesser every year on their birthday (and 30 days after).
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What is Gabapentin?
This medication can be used to treat serious health concerns such as diabetic neuropathy, but can also be used to treat harmless concerns like Restless Leg Syndrome.
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What are Missouri and New Jersey?
These states only offer dental coverage with Aetna. (No vision or hearing)
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What is UHC, Aetna family, Cigna, Humana.
Carriers that do not follow the 2x2x2 rule (or stricter guidelines).
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What is a KO?
A client who says "I went to the hospital last year and my doctor said I was in a-fib, but I haven't had any issues since he put me on a pill."
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What are CT, MA, MN, NY, OH, PA, RI, VT?
These states have no excess charges, important to note when pitching Plan N in these states.
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What is Memory loss? (Alzheimer's, dementia)
Aricept, Razadyne, and Namenda are declinable drugs for what type of condition?
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What are narcotics?
Percocet, Hydrocodone, Fentanyl, and Tramadol are all types of what category of declinable drugs?
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What is Cigna, Mutual of Omaha/GPM?
Carriers that will decline a client who started seeing a psychiatrist monthly a year ago.
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What is a KO?
A client who is is diabetic and takes 2 meds for his heart, 1 for his diabetes, and 1 for his feet.
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What are ID, IN, KS, MD, OH, OR, UT?
These states offer combination Cancer, Heart Attack & Stroke policies with Aetna.
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What is Osteoporosis with fractures, HKO?
A client taking lisinopril, gabapentin, and alendronate has no health concerns except for a fractured wrist last year. This is the UW rule that will tell us she is ____. (HKO/Good to Go)
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What are blood thinners?
Eliquis, Xarelto, and Warfarin are all this type of drug commonly the cause of a client being HKO?
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